Short Physical Performance Battery and Incident Cardiovascular Events Among Older Women.
Short Physical Performance Battery and Incident Cardiovascular Events Among Older Women.
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DOI：
10.1161/jaha.120.016845
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发表时间：
2020-07-21
影响因子：
5.4
通讯作者：
LaCroix AZ
中科院分区：
文献类型：
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作者：
Bellettiere J;Lamonte MJ;Unkart J;Liles S;Laddu-Patel D;Manson JE;Banack H;Seguin-Fowler R;Chavez P;Tinker LF;Wallace RB;LaCroix AZ
短期身体机能测试 (SPPB) 是一种廉价、可靠且易于实施的下肢身体机能测量方法。有强有力的证据将 SPPB 评分与全因死亡率联系起来，但对其与心血管疾病 (CVD) 事件的关系知之甚少。无心肌梗死或中风病史的女性（n=5043，平均年龄=79±7）完成了 3 项定时评估——站立平衡、力量（5 个椅子站立）和通常步态速度（4 m 步行）——得出 SPPB 评分从 0（最差）到 12（最好）。对女性的 CVD 事件（心肌梗死、中风或 CVD 死亡）进行长达 6 年的随访。使用针对人口、行为和健康相关变量（包括体力活动、血压、血脂和血糖水平的客观测量）进行调整的 Cox 比例风险模型，估算了 SPPB 评分极低（0-3）、低（4-6）、中（7-9）和高（10-12）女性的风险比。受限三次样条测试关联的线性度。在 361 例 CVD 病例中，极低、低、中和高 SPPB 类别的粗发病率/1000 人年分别为 41.0、24.3、16.1 和 8.6。相应的完全调整风险比（95％CI）为2.28（1.50-3.48）、1.70（1.23-2.36）、1.49（1.12-1.98）和1.00（参考值）； P-趋势 <0.001。剂量反应关系呈线性（线性P<0.001；非线性P>0.38）。结果表明，SPPB 可以提供除传统危险因素之外的老年人心血管健康指标。由于其重测可靠性高且管理负担低，SPPB 应成为基于办公室的 CVD 风险评估的常规部分。
The Short Physical Performance Battery (SPPB) is an inexpensive, reliable, and easy‐to‐implement measure of lower‐extremity physical function. Strong evidence links SPPB scores with all‐cause mortality, but little is known about its relationship with incident cardiovascular disease (CVD). Women (n=5043, mean age=79±7) with no history of myocardial infarction or stroke completed 3 timed assessments—standing balance, strength (5 chair stands), and usual gait speed (4 m walk)—yielding an SPPB score from 0 (worst) to 12 (best). Women were followed for CVD events (myocardial infarction, stroke, or CVD death) up to 6 years. Hazard ratios were estimated for women with Very Low (0–3), Low (4–6), Moderate (7–9), and High (10–12) SPPB scores using Cox proportional hazard models adjusted for demographic, behavioral, and health‐related variables including objective measurements of physical activity, blood pressure, lipids, and glucose levels. Restricted cubic splines tested linearity of associations. With 361 CVD cases, crude incidence rates/1000 person‐years were 41.0, 24.3, 16.1, and 8.6 for Very Low, Low, Moderate, and High SPPB categories, respectively. Corresponding fully adjusted hazard ratios (95% CIs) were 2.28 (1.50–3.48), 1.70 (1.23–2.36) 1.49 (1.12–1.98), and 1.00 (referent); P‐trend <0.001. The dose‐response relationship was linear (linear P<0.001; nonlinear P>0.38). Results suggest SPPB may provide a measure of cardiovascular health in older adults beyond that captured by traditional risk factors. Because of its high test‐retest reliability and low administrative burden, the SPPB should be a routine part of office‐based CVD risk assessment.